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Hi All

Postby Del » 02 Dec 2009, 07:28

Hi All,
I'm 53 and have been suffering with fissures (a fissure?) since my late twenties. I normally have pain for a week or two and then recovery for another week after that, so most of my episodes last two to three weeks. I can then be 'normal' for months, even up to a year and a half but the fissure always raises its ugly head eventually.
I have been to see doctors previously but they have never been sure if it was a fissure or internal hemmorhoids. What is it about doctors? You tell them you are in agonising pain and the first thing they want to do is shove something up your butt!! They then refer me to a specialist who cant see me for a month or two and by the time he checks it out theres nothing there but some scars.
Anywho, my most recent episode started about a day after my doctor checked my prostate with her finger (could this have started it off?). It seemed to be progressing normally then some thing went wrong after about nine or ten days (perhaps a harder BM?) and the pain went into overdrive.
I went back to see the doc and she said it sounded like a fissure, when she looked she could see one but wanted to check that there were no other problems and started trying to insert something the size of a cruise liner up my bottom. I think they heard the scream of pain a mile away.
She gave up at that point and prescribed rectogesic, which didn't seem to do anything at least at first anyway. About two and a half weeks ago I had two days of excruciating pain where my wife thought I was going to cry. The only thing able to relieve it slightly was a good hot bath. We have a whirlpool spa bath so I put the bubbles on low and let them play over the affected area. I get that the fissure hurts but why does your whole butt feel as though you were kicked by a horse?
Went to see the doctor again and tried to describe the pain and she prescribed lidocaine which was pretty useless to be honest it stung more when I used it than if I used nothing.
I wouldn't wish this pain on my worst enemy but sometimes it would be nice for the doctor to feel what you feel, I am sure they would be much more focused on removing the pain!
I seem to be getting better at the moment, I can now pass a BM without the immediate pain I just get the pain for about 6 to 8 hours after and i get these 'pulses' of pain.
Been managing it with hot baths, rectogesic, lidocaine, daily doses of lactulose (a mild laxative) and regular drinks of some stuff like bird seed called Lepicol.
Do not want another two months plus of pain again and feel sorry for those of you who seem to suffer continuously.
Del
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Re: Hi All

Postby cherylk » 02 Dec 2009, 07:42

Del,
I wanted to say welcome. We have had some people here for the UK. I wouldn't let anyone shove something up my butt when I had my AF, so I can sympathize with your pain during an exam!! This is a great place for you to get support and learn. Image
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Re: Hi All

Postby sidra1968 » 02 Dec 2009, 08:08

Welcome!
We know how excruciating and life consuming the pain can be..I had LIS surgery in August and am basically "cured". I take Miralax every night to prevent a re-tear. You may want to consider it if it becomes unbearable. Yours sounds interesting as it heals, retears, heals, retears. Mine never really went away more than 2 times and that was for 8 months the first time and only 2 weeks the second. After that, I was either gonna get surgery or jump off a bridge..LOL
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Re: Hi All

Postby suzyljank » 02 Dec 2009, 10:23

Hi and welcome. The digital exam for prostate could have aggravated or caused a fissure especially if you tightened up during the exam. Your doctor should not have tried a digtial exam later especially since she already saw an active fissure. The first thing you need to do is soften up your stool. This will make having a bm less painful. I personally use miralax at bedtime and benefiber 3 times during the day. I eat a high fiber cereal twice a day, drink more liquids and then eat pretty much what I want the rest of the time. Miralax might take a few days to kick in so give it time and it's completely adjustable. If you need more or less. I'll be on it the rest of my life but if it makes going to the bathroom less stressful I'm okay with that. See if you can get your doctor to prescribe nifedipine or nitro ointment. They help relax the sphincter muscle so the fissure can heal. If none of this helps please find a good CRS and they should be able to help you. We've all been there and some of us many times so please hang in there and glad you found us. This is a good group of people to come to for advice and encouraging words. Suzy
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Re: Hi All

Postby Del » 02 Dec 2009, 11:22

Hi Cheryl, Suzy and Sidra. Thanks for the welcome.
I don't know if Miralax is available over here, apart from on E-bay. The Lactulose definitely seems to help me.
The Rectogesic is a Nitro based product Nitro Trinitate Glycerin or something. And the Lepicol is I think based an psylium husks which i need to drink loads of water with. If I leave the Lepicol in the glass it seems to almost form a jelly like substance which is possibly what helps me.
Definitely think I'm on the mend at the moment (till the next episode) so hopefully the Rectogesic etc is doing its stuff, just so worried that I will take another backward step.
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Re: Hi All

Postby cherylk » 02 Dec 2009, 11:49

Del,
I think Lactulose is similar to Miralax. Miralax=Movicol in the UK (same stuff). Lepicol sounds similar to Metamucil which we have in the US. Rectogesic is probably similar to nitro/nifedipine/diliatzem. Good luck!
Cheryl
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Re: Hi All

Postby NeuropathicGuy » 03 Dec 2009, 13:36

Hey Del, your symptoms sound like a fissure to me but I'd think the doctors should be sure before starting treatment, especially if the problem has been around for so long. It's not real feasible to do a proper butt exam in the standard manner when there's an active fissure, but that doesn't mean such an exam can't be done at all.
I had one episode with my fissure where I was completely devoured by the pain and couldn't walk or stand. I was carried into the ER and put under conscious sedation for a rectal exam. Despite the all-consuming pain I was in upon presenting to the hospital, I didn't feel a single thing from the exam and they were able to visualize a fissure and be sure that's what I was dealing with.
I also later had a colonoscopy while having an active fissure and I didn't feel any pain from the fissure during that either.
Anyhow I guess my point is it kind of sounds like the doctors are guessing a bit right now, which frankly is fine in most cases since fissures can often be diagnosed based on clinical symptoms alone, but that more certain means are available if you desire or require them. I'm not sure if or how you could request to be sedated for a rectal exam over in the UK, but I didn't have any problems here in the States. Treatment for say a thrombosed hemorrhoid would be different than treatment for an anal fissure so to me the distinction is important to make.
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Re: Hi All

Postby NeuropathicGuy » 03 Dec 2009, 13:42

I should also add that I have both hemorrhoids and a fissure and the fissure is definitely the more painful of the two. But my hemorrhoids aren't thrombosed which I understand comes with extreme pain too. The feeling of your whole bum being kicked by a horse sounds like a sphincter spasm due to the fissure to me. When my fissure first started, I often felt an insanely uncomfortable spasm in my sphincter that made it very difficult to sleep at night and only subsibed maybe 12 hours or so after a bowel movement.
Oh yeah +1 for Miralax/Movicol for me too. I tried various stool softeners and fiber adders and Miralax was the only one that helped me. In fact it may have helped me too well because it has allowed me to keep the fissure pain manageable for the last half year or so, and has made me a bit lazy about getting more invasive treatments like surgery to actually fix the problem once and for all. I can't complain, though, before Miralax I was in excruciating pain every day, after Miralax I have mild-moderate pain and some occasional bleeding which is orders of magnitude more tolerable.
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